Background and study aims? Several Latin American countries, including Mexico, have reported an increase in colorectal cancer (CRC) mortality. The effectiveness of a colonoscopy in preventing CRC depends on the quality of the procedure, for which the adenoma detection rate (ADR) is one of the most trusted indicators. Awareness of ADR can improve the quality of colonoscopies through proper feedback and training of the specialists. The goal of this study was to estimate the ADR among Mexican endoscopists with experience in CRC screening and to compare it with previously reported data from this country. Methods? We carried out a retrospective study to analyze ADR data in Mexico. The information was obtained from a group of certified endoscopists and compared with the former published data from Mexico. Results? We found a current ADR of 24.6?% (95?%CI, 22.4?%-26.8?%) from 1,478 colonoscopies performed by eight endoscopists in two third-level private hospitals. The average ADR reported in previous publications was 15.2?% (95?%CI, 13.3?%-17.1?%). Statistical analysis showed differences between our results and those from previous studies (24.6 % vs. 15.2?%, P ? less then ?0.001). Conclusions? The actual ADR in Mexico is higher than previously reported. Previous low ADR values could be explained by poorly performed colonoscopies rather than by low adenoma and CRC incidence in our country.Background and study aims? Argon plasma coagulation (APC) is an effective and safe modality for many gastrointestinal conditions requiring hemostasis and/or ablation. However, it can be quite costly. A potentially more cost-effective alternative is snare-tip spray coagulation (SC). This study aimed to determine whether SC would be a safe and effective alternative to APC using an ex-vivo model. Methods? Using two resected porcine stomach, 36 randomized gastric areas were ablated for 2 seconds with either APC at 1.0?L/min 20?W (APC20) and 1.4?L/min 40?W (APC40) or SC with Effect 2 60?W (SC60) and 80?W (SC80) from 3?mm. Extent of tissue injury was then analyzed histopathologically. Results? The mean coagulation depth was 790?±?159??m and 825?±?467??m for SC60 (n?=?9) and SC80 (n?=?8), respectively. This was compared to 539?±?151??m for APC20 (n?=?8) and 779?±?267??m for APC40 (n?=?9). Mean difference (MD) in coagulation depth between SC60 and APC40 was 12??m (95?% confidence interval [CI], -191 to 214 ?m; P ?=?0.91) and was 47??m (95?%CI, -162 to 255 ?m; P ?=?0.81) between SC80 and APC40.?There was a greater depth of injury with APC40 (MD, 240 ?m; 95?%CI, 62 to 418??m; P ?=?0.04) and with SC60 (MD, 252??m; 95?%CI, 141 to 362??m; P ?=?0.004) when compared to APC20. Mean cross-sectional area of coagulation was 2.39?±?0.852 mm? for SC60 and 2.54?±?1.83?mm? for SC80 compared to 1.22?±?0.569 mm? for APC20 and 1.99?±?0.769?mm? for APC40.?Seventy-eight percent reached the muscularis mucosa (MM) and 11?% the submucosa in the SC60 group compared to 50?% and 38?% in SC80 and 56?% and 11?% in APC40, respectively. Thirty-eight percent of APC20 specimens reached the MM. The muscularis propria was unaffected. Conclusions? This small ex-vivo study suggests that SC60 and SC80 may be safe alternatives to APC40 with comparable coagulation depths and area effects.Background and study aims? Gastrointestinal cancer is an important cause of death worldwide. Remote populations are especially vulnerable to these conditions due to reduced access to screening and adequate treatment. In this context, the Belterra project was designed as a pilot taskforce to deliver gastrointestinal screening to an underserved Amazonian population and to spread knowledge and practice to local health workers. This study aimed to describe the implementation and present the results of the Belterra Project. Patients and methods? The project took place between October 2014 and December 2017 in Belterra, Pará, Brazil. Public-private partnerships were obtained and were essential for funding. The project required complex logistic solutions to provide gastrointestinal screening to every inhabitant between 50 and 70 years of age, including medical equipment and personal transportation to a remote area. Subjects were asked about their medical history, and received a physical examination, endoscopic examinations, and stool tests. https://www.selleckchem.com/products/repsox.html Results? Over the course of 19 expeditions, we screened 2,022 inhabitants of Belterra, aged 50 to 70 years. Five colorectal and six gastric adenocarcinomas were diagnosed, as were several lower-stage lesions. Overall, 26?% of the participants undergoing colonoscopy showed some type of colonic lesion. Conclusions? Notwithstanding the geographical, cultural, and financial barriers, this study suggests that the implementation of a gastrointestinal cancer screening program for remote Brazilian populations is feasible, reaching high adherence. Although logistics is very demanding, such campaigns may be a good strategy to provide mass gastrointestinal cancer screening for underserved populations.Backgrounds and study aims ?Treatment of octogenarian patients with achalasia with conventional treatments is effective but with compromised safety. Biodegradable stents (BS) are promising. We aimed to evaluate their safety, efficacy and clinical outcomes at early, mid and long-term in this population. Patients and methods? Naïve or previously-treated achalasic octogenarian patients underwent to BS placement (BSP) between December, 2010 and November, 2011, and were followed-up for 9-years. A strict follow-up was performed. Results? Thirty-two patients were included, (17 men [53.1?%]; median age 82 years [78-92]). BSP was performed in all patients. At 9y, 18/32 (56.2?%) completed protocol. Mean BSP time was 37.5±12.1?min and 34.4?% presented thoracic pain. At 1?m, six BS were migrated (18.7?%), requiring a second BSP fixed with hemoclips. At 3?m, twenty-three (72.8?%) completed degradation process. At 6?m, eighteen (56.2?%) presented clinical dysphagia, of whom 5/32 (15.6?%) presented stenotic-tissue hyperplasia, responding to balloon dilation in all cases.